Nursing Elites

1. A nurse is caring for a client prescribed methotrexate for rheumatoid arthritis. Which of the following client history findings requires the nurse to question the administration of this medication?

• A. Osteoporosis
• B. Hypertension
• C. Peptic ulcer disease
• D. Immunosuppression

Correct answer: C

Rationale: The correct answer is C: Peptic ulcer disease. Methotrexate can exacerbate peptic ulcer disease, leading to serious complications. This finding warrants questioning the administration of methotrexate to prevent harm to the client. Choices A, B, and D are not directly contraindicated with methotrexate use. Osteoporosis, hypertension, and immunosuppression are not typically reasons to question the administration of methotrexate for rheumatoid arthritis.

2. A nurse is providing client education regarding lithium therapy. Which of the following instructions should the nurse include?

• A. Take with food to decrease nausea
• B. Avoid excessive intake of caffeinated beverages
• C. Monitor for signs of dehydration
• D. Restrict salt intake to prevent water retention

Correct answer: B

Rationale: The correct answer is B. The nurse should instruct the client to avoid excessive intake of caffeinated beverages as they can interfere with lithium levels. Option A is incorrect as lithium is usually recommended to be taken on an empty stomach. Option C is not directly related to lithium therapy. Option D is not a typical instruction for lithium therapy.

3. A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacologic action of this medication?

• A. To stimulate the pancreas to secrete insulin
• B. To slow the absorption of glucose in the intestine
• C. To increase reabsorption of water in the renal tubules
• D. To increase blood pressure

Correct answer: C

Rationale: The correct answer is C: To increase reabsorption of water in the renal tubules. Vasopressin, also known as antidiuretic hormone (ADH), works by increasing the reabsorption of water in the renal tubules, which helps to concentrate urine and reduce excessive urination in diabetes insipidus. Choice A is incorrect as vasopressin does not stimulate the pancreas to secrete insulin. Choice B is incorrect as vasopressin does not affect the absorption of glucose in the intestine. Choice D is incorrect as vasopressin's primary action is not to increase blood pressure, although it can have some vasoconstrictive effects.

4. A nurse is preparing to administer furosemide to a client. Which of the following findings indicates the client may be at risk for an adverse effect of the medication?

• A. Hypertension
• B. Hypokalemia
• C. Increased urine output
• D. Hyperglycemia

Correct answer: B

Rationale: The correct answer is B: Hypokalemia. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia, which is a common adverse effect. Hypokalemia can result in serious complications like cardiac arrhythmias. Choices A, C, and D are not directly associated with the adverse effects of furosemide. Hypertension is a condition that furosemide is often used to treat, increased urine output is an expected effect of furosemide, and hyperglycemia is not a typical adverse effect of this medication.

5. A healthcare provider has just administered a wrong medication to a client. Which of the following actions should the provider take next?

• A. No action is needed
• B. Report error to the provider
• C. Complete an institutional incident report
• D. Inform the client that the wrong medication was given

Correct answer: B

Rationale: In the scenario where a wrong medication has been administered, it is crucial for the healthcare provider to report the error to the provider. This action is essential to ensure that the provider is informed promptly, corrective measures are taken, and the client's well-being is safeguarded. Choice A is incorrect as taking no action could lead to serious consequences and compromise patient safety. Choice C, while important, should come after reporting the error to the provider. Choice D is not the immediate priority as the provider should first focus on addressing the error internally.

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